Job Description:

Conduct medical record reviews to assess eligibility, determine medical necessity, and process authorizations or denials for services under the California Children's Services (CCS) program.

Manage a caseload (ages birth to 21) with complex medical conditions, including cerebral palsy, heart disease, and cancer, completing 10-15 reviews per day.

Assist families in navigating healthcare services, including scheduling appointments, coordinating surgeries, and facilitating inpatient stays.

Communicate regularly with healthcare providers and families via phone and multiple software systems to ensure continuity of care and service approvals.

Schedule/Shift:

Monday - Friday: 8am - 5pm (ONSITE)

Qualifications:

• RN license
• Case management or Pediatrics experience

Pay: $50/hr

***Please note is role is TEMPORARY until 3-6 months***